title: Changes in diet and physical activity resulting from the Shape Up Somerville community intervention.
abstract: BACKGROUND
  The purpose of this study is to describe the behavioral changes in children resulting from Shape Up Somerville (SUS), a community-based, participatory obesity prevention intervention that used a multi-level, systems-based approach. It was set in Somerville, an urban, culturally diverse community in Massachusetts, USA.
  
  
  METHODS
  This was a non-randomized, controlled 2-year community-based intervention trial with children enrolled in grades 1 to 3 (ages 6-8 years). Overall, the SUS intervention was designed to create environmental and policy change to impact all aspects of a child's day. Pre-post outcomes were compared between Somerville and two control communities that were chosen based on socio-demographic similarities. Behavioral outcomes were fruit and vegetable and sugar-sweetened beverage consumption; number of organized sports and physical activities per year; walking to and from school; screen and television time; television in bedroom; and dinner in room with television on. These measures were assessed by parent/caregiver report using a 68-item Family Survey Form. Data were analyzed using multiple linear regression, accounting for covariates and clustering by community.
  
  
  RESULTS
  Intervention group children, compared to the control group, significantly reduced sugar-sweetened beverage consumption (-2.0 ounces per day; 95% CI -3.8 to -0.2), increased participation in organized sports and physical activities (0.20 sports or activities per year; 95% CI 0.06 to 0.33), and reduced their screen time (-0.24 hours per day; 95% CI -0.42 to -0.06).
  
  
  CONCLUSIONS
  Results of this study, particularly intake of sugar-sweetened beverages and screen time, are similar to others that used a multi-level approach to realize change in behavior. These results support the efficacy of a multi-level and systems-based approach for promoting the behavioral changes necessary for childhood obesity prevention. This study is registered at ClinicalTrials.gov as NCT00153322.
authors.affiliation: John Hancock Research Center on Physical Activity, Nutrition, and Obesity Prevention, Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA 02111, USA. sara.folta@tufts.edu.
authors.forename: Sara C
authors.initials: SC
authors.lastname: Folta
authors.forename: Julia F
authors.initials: JF
authors.lastname: Kuder
authors.forename: Jeanne P
authors.initials: JP
authors.lastname: Goldberg
authors.forename: Raymond R
authors.initials: RR
authors.lastname: Hyatt
authors.forename: Aviva
authors.initials: A
authors.lastname: Must
authors.forename: Elena N
authors.initials: EN
authors.lastname: Naumova
authors.forename: Miriam E
authors.initials: ME
authors.lastname: Nelson
authors.forename: Christina D
authors.initials: CD
authors.lastname: Economos
mesh_terms: D015992:Body Mass Index; D016022:Case-Control Studies; D002648:Child; D055812:Community-Based Participatory Research; D003201:Computers / Q000706:statistics & numerical data; D003625:Data Collection; D004032:Diet / Q000706:statistics & numerical data*; D015444:Exercise; D005247:Feeding Behavior; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D009765:Obesity / Q000517:prevention & control*; D015397:Program Evaluation; D013177:Sports / Q000706:statistics & numerical data; D013690:Television / Q000706:statistics & numerical data